ZKEA

Biological Terrorism : Emerging Diseases : Biological Warfare

Health Systems, Breakdown

However, pathogenic organisms have not remained still. New ones have evolved and old ones have attained new capabilities such as antibiotic resistance. Further, due to social or governmental breakdown, health systems in much of the world have declined. This is also true in some western countries, in addition to the third world. Thus, many populations around the globe face deepening threats from infectious disease.

Cholera is a good example. Cholera is an efficient historical killer of people, but it is a well-understood killer. The key to prevention of the disease is simple: clean water. Given clean water supplies and good public hygiene, cholera is virtually never a problem. Because of this cholera was one of the first diseases to be "conquered".

Over the past few years, however, the conquered bacterium has returned. In India and Africa, mortality from cholera is increasing rapidly. And the disease has even spread to previously unaffected areas. In 1991 cholera hit Peru and then spread down the west coast of South America. Eventually the disease even made its way to North America. The New World, once a cholera-free zone, now appears to be permanently afflicted.

What is causing this resurgence? As is usually the case, the answer is complex: failing health systems, pollution of previously clean water supplies, wars and population dislocations, changing weather patterns. Even globalization contributes - the cholera bacterium that hit Peru may have been imported via a ship from India.

Vaccination is another area in trouble. Vaccination is by far the most cost-effective way to prevent a whole range of diseases. However, some populations are increasingly unvaccinated. Sometimes this lack of vaccination is driven by the mistaken notion that a disease no longer poses a threat (such as smallpox). Other times, such as in the United States, it's driven by religious or personal-liberty convictions against vaccination, even when these convictions are contrary to a family's own children or the public health at large. Sometimes conspiracy theories among less-educated people block vaccination, such as the belief among some that vaccination itself causes the disease in question. Lastly, sometimes failure is simply due to governmental ineptitude or by fundamental tears in the social fabric.

This is the case in much of Africa. Poor government over decades has eroded the original colonial infrastructure. This, combined with the effects of the HIV epidemic, has catalyzed a wave of secondary epidemics in a number of countries. This is also true in parts of Asia and Latin American, such as India. Here the situation is exacerbated by ethnic and religious tension. An example of this dynamic in India is the problem with polio.

In India the rate of polio is increasing. Given polio is easily blocked via childhood vaccination, how is that possible?

The problem is one of education and ethnic violence. Among Indian poor (especially Muslims), there is growing distrust of vaccination. Rumors have been spread that polio vaccination in particular will cause sterility. Others detect a conspiracy against them.

Therefore many families are hostile to these programs and refuse to get vaccinated. As a result, polio has returned with a vengeance.

India, at least, has a functioning health-care system, albeit one that must wrestle with great poverty. Other nations are less lucky and now face even greater challenges.

In the United States, objection to vaccination largely comes from the poorly-educated and from certain religious sects and cults. Generally, an exemption is granted in cases of religious objection, even when such an exemption places both the individual and the larger society at risk.

Link 1: Science News: Vaccines Benefit and Risks
Link 2: New York Times: Distrust Opens the Door For Polio (India, Islam)
Link 3: Cholera Returns
Link 4: CDC: Six common misconceptions about vaccination
Link 5: CDC: Example of measles spred in unvaccinated population
Link 6: Zambia: Health System Breakdown Leading To Epidemics